One breast cancer patient and visitor to City of Hope’s Facebook page recently voiced her frustration with the lack of answers, writing: “No one can tell me where the cause of my cancer came from. Speculation is all that there is!”

The “hucksters and snake oil salesmen type people claiming remedies for this awful disease” were particularly troubling to her. “Why isn’t more being said about what is real and what is a hoax. What is the truth about parabens? If they are so bad, why is the stuff so common? What is the truth about plastic? … All this hype is worse than going through chemotherapy.”

Cy Stein, M.D., Ph.D., the Arthur & Rosalie Kaplan Chair in Medical Oncology at City of Hope and the deputy director for clinical research, is both sympathetic about the need for answers and optimistic that, eventually, we’ll get them.

“At this point in time, no one can tell you with certainty where your breast cancer came from,” he responded. “Cosmologists can describe the evolution of the universe from a fraction of a second after its birth at the Big Bang until now; but when biologists look the other way, through the microscope lens at living cells, we see one mystery piled upon another. Sometimes I'm convinced the complexity of a single cell is greater than that of the remainder of the universe entire.”

And he himself is vexed at those trying to mislead for personal gain. “There are many people trying to pour snake oil in sick people's wounds – which is precisely why people with cancer need to seek treatment in reputable institutions, i.e., those whose mission is patient care and rigorously peer-reviewed research,” he wrote.

That kind of research, that search for answers, is what we do at City of Hope.

"It's only through more research that the questions you ask can be answered," says Cy Stein, the Arthur & Rosalie Kaplan Chair in Medical Oncology at City of Hope.

“It's only through more research that the questions you ask can be answered – and I have a strong sense that the answers, like everything else about this disease, will be complex and ringed with contingencies,” Stein wrote. “I know you may feel these thoughts are ambiguous and unsatisfying, but there are tens of thousands of well-intentioned people working on these questions every day, not only at City of Hope, but all around the world.”

His response may not be the answer that cancer patients want. But it's where their answer starts.